Real-world assessment of the patient profile, clinical characteristics, treatment patterns, and outcomes associated with erythropoietic and X-linked protoporphyria.

Samuel M Silver, Katherine Houghton, Abby Hitchens, Valérie Derrien Ansquer, Malgorzata Ciepielewska
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Abstract

Erythropoietic protoporphyria (EPP) and X-linked protoporphyria (XLP) are rare genetic disorders. There are limited data regarding how these disorders are managed in real-world settings. The aim of this study was to document the characteristics and treatment patterns among patients diagnosed with EPP or XLP in general real-world settings in the United States. We, therefore, conducted a retrospective medical record review of patients diagnosed with EPP or XLP on or before July 1, 2020. Data were analyzed for patients with EPP (n = 299) and XLP (n = 91). Outcomes included demographic and clinical characteristics, diagnostic testing, therapy recommendations, office visits, emergency department visits, and hospitalizations. Costs were assigned to healthcare resources. Mean (standard deviation [SD]; median) time between the first symptom documented in the medical records and diagnosis was 2.9 (5.1; 1.3) years. The most common pre-diagnostic tests were liver function, total plasma and erythrocyte protoporphyrin, genetic tests, and renal function. Patients were advised to use sunscreen (85%) or modify their lifestyle (83%). Within 12 months of diagnosis, the mean (SD; median) number of office visits, emergency department visits, and inpatient hospitalizations related to EPP or XLP were 4.0 (3.5; 3.0), 0.8 (1.6; 0), and 0.4 (1.3; 0), respectively. Patients with EPP or XLP have several unmet needs, including timely and accurate diagnosis, symptom relief, and efficacious prevention of phototoxic reactions.

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红细胞生成和x连锁原卟啉症的患者概况、临床特征、治疗模式和结果的真实评估。
红细胞生成性原生卟啉症(EPP)和x连锁原生卟啉症(XLP)是罕见的遗传性疾病。关于在现实环境中如何管理这些疾病的数据有限。本研究的目的是记录在美国一般现实环境中诊断为EPP或XLP的患者的特征和治疗模式。因此,我们对2020年7月1日或之前诊断为EPP或XLP的患者进行了回顾性医疗记录审查。对EPP (n = 299)和XLP (n = 91)患者的数据进行分析。结果包括人口统计学和临床特征、诊断测试、治疗建议、办公室就诊、急诊就诊和住院情况。费用分配给保健资源。平均值(标准差[SD];从医疗记录中记录的首次症状到诊断的中位时间为2.9 (5.1;1.3)年。最常见的诊断前检测是肝功能、总血浆和红细胞原卟啉、基因检测和肾功能。建议患者使用防晒霜(85%)或改变他们的生活方式(83%)。在诊断的12个月内,平均(SD;与EPP或XLP相关的办公室就诊次数、急诊科就诊次数和住院次数中位数为4.0 (3.5;3.0), 0.8 (1.6;0), 0.4 (1.3;分别为0)。EPP或XLP患者存在及时准确诊断、症状缓解、有效预防光毒性反应等未满足的需求。
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